A variety of extracorporeal techniques have been described in surgery of the descending thoracic and thoracoabdominal aorta. We describe an operative approach involving the cannulation of the pulmonary artery for venous drainage in 12 patients undergoing descending thoracic aortic surgery. In-hospital mortality was 17%; there were no in-hospital deaths for elective cases. There were no cases of...

Complex lesions of the thoracic aorta are traditionally treated in 2 surgical steps with the elephant trunk technique. A relatively new approach is the frozen elephant trunk (FET) technique, which potentially allows combined lesions of the thoracic aorta to be treated in a 1-stage procedure combining endovascular treatment with conventional surgery using a hybrid prosthesis. These are very comp...

We describe a patient who developed embolic stroke after coronary artery bypass grafting (CABG) associated with intraaortic balloon pump (IABP) insertion. Intraoperative transesophageal echocardiography (TEE) revealed marked irregular mass and disruption of the intimal surface of the thoracic aorta with overlying shaggy echogenic material on the intimal surface of the descending thoracic aortic...

BACKGROUND AND PURPOSE Proximal aortic plaques, especially in the aortic arch, have already been established as an important cause of stroke and peripheral embolism. However, aortic plaques situated in the descending thoracic aorta have recently been postulated as a potential embolic source in patients with cryptogenic cerebral infarction through retrograde aortic flow. The aim of the present s...

T ransoesophageal echocardiography (TOE) is often the initial investigation of choice for imaging acute and chronic aortic disease including dissection and ectasia. It is also used in the placement of endovascular stent grafts, to monitor deployment of the stent, and to assess results. It is ideally suited because of the close proximity of the oesophageal imaging window to the arch and descendi...

Objective(s): Cardiovascular disease is a leading cause of morbimortality with over half cardiovascular events occurring in the asymptomatic population by traditional risk stratification. This preliminary study aimed to evaluate systemic plaque vulnerability in patients with prior Coronary Artery Disease (CAD) with a single Whole Body [FDG] PET-CT scan in terms of plaq...

We investigated the effect of intraluminal pressure or stretch on the development of tone in the descending thoracic aorta from rats with aortic coarctation-induced hypertension of 7-14 days duration. Increments of pressure >100 mmHg decreased the diameter of thoracic aortas from hypertensive but not from normotensive rats. The pressure-induced constriction was not demonstrable in vessels super...

BACKGROUND AND PURPOSE Acute paraplegia must be investigated promptly to exclude reversible causes. In this report we illustrate the usefulness of transesophageal echocardiography in identifying the vascular etiologies of acute paraplegia. CASE DESCRIPTIONS Two patients presented with acute paraplegia, one spontaneously and the other after removal of an intra-aortic balloon pump catheter. Thr...

PURPOSE To examine the feasibility of a direct videoscopic approach to the descending thoracic aorta for endograft delivery to the aortic arch. METHODS A double purse-string suture was placed on the aorta of 3 pigs via a thoracoscopic approach. Subsequently, the aorta was cannulated in the center of the purse-string. A 22-F delivery catheter was advanced under fluoroscopic control over a guid...

Aortoesophageal fistula (AEF) is a rare but fatal cause of gastrointestinal hemorrhage, being most commonly associated with thoracic aortic aneurysm. We present a rare case of secondary AEF post graft treatment for mycotic aneurysm of thoracic aorta 4 years previously. Massive upper gastrointestinal hemorrhage resulted in difficult diagnosis by gastrointestinal endoscopy. Computed tomography an...